Exhibit 2- Safety National Insurance Proposal
Insurance Proposal for
City of Denton, TX
Policy Effective Date
12/31/2021
Policy Expiration Date
12/31/2022
2
Date: 11/23/2021
To: Lockton Companies
Attention: Neil Cohen
From: Codi Bolding
Named Insured: City of Denton
We are pleased to present the following proposal for your consideration and review. This proposal is
valid until the effective date indicated in this proposal.
Line of Coverage Premium and Surcharges
General Liability Coverage $68,882
Commercial Automobile Liability Coverage $72,898
Commercial Automobile Physical Damage Coverage $137,068
**Public Officials Liability Coverage $55,909
**Law Enforcement Liability Coverage $77,101
Excess Liability $60,168
Total $472,026
Optional TRIA Coverage: (excluded in pricing above)
Line of Coverage Premium and Surcharges
GL TRIA $620
Excess TRIA $1,805
Indicated premiums are based on all quoted lines of coverage, including Excess Workers’
Compensation Insurance, being bound according to the terms and conditions included within Safety
National’s proposals. With the exception of Surplus Lines, the taxes, surcharges, assessments and
other program costs are included within the premium for each line of coverage offered by Safety
National Casualty Corporation. Premiums are fully earned when bound.
** These coverages are offered by Safety Specialty Insurance Company, a Surplus Lines Carrier.
Premium does not include any surplus lines taxes and fees. Filing, collection and remittance of all
Surplus Lines taxes and fees will be your responsibility.
Safety National may consider providing revised or additional quote options for individual lines of
coverage subject to further underwriting review and approval.
Unless otherwise noted, all references in this proposal to policy coverage parts and forms, depicts
the product offering of Safety National. These may deviate from the coverage requests or wording
contained within the Producer Specifications or other portions of the account submission.
Any deviations from this proposal must be approved and authorized by Safety National, in writing.
For additional information on the products and services proudly provided by Safety National, please
visit our website: www.safetynational.com
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General Contingencies and Comments
Commission This proposal is net of commission.
Risk Control Services All Safety National Clients have access to MAP, our
online Safety and Risk Control resource. The City of
Denton has $10,000 of Risk Control Funds to use
during this policy period.
Coverage Contingencies The casualty program is contingent upon also binding the
Excess Workers’ Compensation program with Safety
National.
Premiums quoted are based on all coverages offered
within this proposal, and within any Excess Workers’
Compensation proposal offered by Safety National, being
written by Safety National Casualty Corporation or
Safety Specialty Insurance Company.
Installments/Payment Schedule All lines are on an Annual Pay Plan. Premiums due
within 30 days of binding. Premiums are fully earned
when bound.
Claims Administration Claims are handled by Gallagher Bassett.
TPA Fees TPA fees are NOT included within the premium or costs
of the quoted Safety National program, unless otherwise
noted herein.
Annual Audits General Liability, Auto Liability, and Specialty Lines are
not auditable.
Surplus Lines Taxes and Fees The broker is responsible for the filing, collection, and
remittance of all applicable surplus lines taxes and fees.
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Management: Several resources that offer a wealth of information and assistance to help your
organization develop and maintain a successful safety and claim cost management program.
Analysis: A variety of tools that provide the ability to measure, benchmark, and analyze different
aspects of your programs to clearly identify opportunities for improvement.
Prevention: A selection of assets to help improve your loss prevention and mitigation efforts – from
educating employees about potential injury exposures, to helping build proficient post-injury protocol.
Resources include:
Safety Essentials Online: This online resource library provides customizable and downloadable training tools
to help improve safety and health compliance, best practices, policies, and written programs.
S:ERVE: Safety Emergency Responder Vehicle Education (S:ERVE) is an online driver simulation and
curriculum created to educate first responders to drive at their safest during intersection negotiation scenarios.
Distracted Driving Course: A course designed to train all employees that drive on the job. Through online
simulation, employees will learn how to eliminate controllable distractions and how to make necessary
adjustments for uncontrollable distractions.
Ask Best Doctors: A Best Doctors specialist will perform three phases of this program for injured workers at
high risk for adverse developments in their medical condition. Available exclusively to our workers’
compensation policyholders.
Crisis Protection: A benefit in place if your entity undergoes a qualifying “Domestic Crisis Event” which aids
in crisis management, public relations, or emergency psychological treatment. Available exclusively to our
workers’ compensation & general liability policyholders.
HR Essentials Online: A Human Resource management and compliance resource library. From hiring
practices and writing job descriptions, to training managers and understanding the ever-complicated leave
laws, this tool delivers the HR resources that every organization needs to succeed. Available exclusively to our
employment practices liability policyholders.
Law Enforcement Liability Resources: A best practices resource program to help address your current
program’s capabilities and develop formal policies and procedures to address areas that are particularly
vulnerable to lawsuits, including jail and detention operations, use of force, and arrest procedures. Available
exclusively to our law enforcement liability policyholders.
For more information, please contact MAP Client Services at map@safetynational.com or 888-995-5300.
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Commercial General Liability Proposal
Safety National Casualty Corporation
A.M. Best Rating A++ XV
Self-Insured Retention Program
Named Insured City of Denton
Effective Date 12/31/2021
Expiration Date 12/31/2022
CGL Coverage Form (CG 00 01) Limits of Liability
General Aggregate Limit $4,000,000 Other than Prod/Comp Ops
Products/Completed Operations Aggregate Limit $4,000,000
Each Occurrence Limit $2,000,000 Combined BI & PD
Personal and Advertising Injury Limit $2,000,000 Any One Person or Org
Damages to Premises Rented to You Limit $500,000 including Fire Damage Legal
Employee Benefits Liability Coverage Limits of Liability
Claims Made Form (SNGL 054)
Aggregate Limit $4,000,000
Each Employee Limit $2,000,000
Retroactive Date Per Expiring
Coverage Retention Form (SNGL 024) Amount ALAE Treatment
CGL - Each Occurrence $500,000
ALAE Within Retention Paid By
Insured
Personal and Advertising Injury $500,000
Damages to Premises Rented to You $500,000
Employee Benefits Liability $500,000
Terms, Conditions, and Subjectivities include, but are not limited to:
• Please provide the expiring Employee Benefits Liability retroactive date upon binding
coverage. If on Occurrence, the retro date will be 12/31/21.
• Confirm in writing that no liability claims have pierced the $500,000 retention x 10 years.
• Confirm in writing that the City no longer has an operable coal or nuclear energy facility, and
that they do not have any plans to operate the like in the future.
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General Liability Coverages / Endorsements
Mandatory State Endorsements As required by covered states
Access or Disclosure of Confidential or Personal
Information And Data-Related Liability Exclusion
CG 21 07
Amended Definition of Bodily Injury SNGL 004
Asbestos Exclusion SNGL 044
Co-Employee Exclusion Deleted SNGL 012
Coverage C- Medical Payments Exclusion CG 21 35
Deletion of Premium Audit Condition SNGL 053
Designated Additional Insured (Broad Form) SNGL 022
Employee Benefits Liability Coverage with Self-
Insured Retention
SNGL 054
Employment Related Practices Exclusion CG 26 39
ERISA Exclusion SNGL 002
Failure to Supply Exclusion CG 22 50
Fungi or Bacteria Exclusion CG 21 67
Governmental Subdivisions Endorsement CG 24 09
Incidental Medical Coverage for: licensed nurses,
psychologist, physical therapist, hearing, language or
speech therapist, EMT, paramedic, or athletic trainer
Manuscript
Injury to Volunteer Firefighters Exclusion CG 22 56
Law Enforcement Exclusion CG 22 51
Lead Exclusion SNGL 043
Nuclear Energy Liability Exclusion IL 00 21
Self-Insured Retention Endorsement SNGL 024
Sexual Abuse or Molestation Coverage GLM 007-2
Silica Exclusion CG 21 96
Pollution Exclusion – Limited Exception for: hostile
fire, emergency operations, HVAC, mobile
equipment, road treatment chemicals,
pesticides/herbicides, water treatment, above ground
tanks, water/sewage operations
CG 04 30/Manuscript
Unintentional Failure to Disclose Hazards or
Occurrences
SNGL 021
TRIA Policyholder Disclosure Notice Per attached disclosure- Signed copy must
be received prior to binding of coverage
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POLICYHOLDER DISCLOSURE
NOTICE OF TERRORISM
INSURANCE COVERAGE
(General Liability)
You are hereby notified that under the Terrorism Risk Insurance Act of 2002, as amended, extended, and/or re-authorized,
you have a right to purchase insurance coverage for losses resulting from acts of terrorism, as defined in Section 102(1) of
the Act: The term “act of terrorism” means any act that is certified by the Secretary of the Treasury – in concurrence with
the Secretary of State and the Attorney General of the United States – to be an act of terrorism; to be a violent act or an act
that is dangerous to human life, property, or infrastructure; to have resulted in damage within the United States, or outside
the United States in the case of certain air carriers or vessels or the premises of a United States mission; and to have been
committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to
influence the policy or affect the conduct of the United States Government by coercion.
YOU SHOULD KNOW THAT WHERE COVERAGE IS PROVIDED BY THIS POLICY FOR LOSSES RESULTING
FROM CERTIFIED ACTS OF TERRORISM, SUCH LOSSES MAY BE PARTIALLY REIMBURSED BY THE
UNITED STATES GOVERNMENT UNDER A FORMULA ESTABLISHED BY FEDERAL LAW. HOWEVER, YOUR
POLICY MAY CONTAIN OTHER EXCLUSIONS WHICH MIGHT AFFECT YOUR COVERAGE, SUCH AS AN
EXCLUSION FOR NUCLEAR EVENTS. UNDER THE FORMULA, THE UNITED STATES GOVERNMENT
GENERALLY REIMBURSES 80% OF COVERED TERRORISM LOSSES EXCEEDING THE STATUTORILY
ESTABLISHED DEDUCTIBLE PAID BY THE INSURANCE COMPANY PROVIDING THE COVERAGE. THE
PREMIUM CHARGED FOR THIS COVERAGE IS PROVIDED BELOW AND DOES NOT INCLUDE ANY
CHARGES FOR THE PORTION OF LOSS THAT MAY BE COVERED BY THE FEDERAL GOVERNMENT UNDER
THE ACT.
YOU SHOULD ALSO KNOW THAT THE TERRORISM RISK INSURANCE ACT, AS AMENDED, CONTAINS A
$100 BILLION CAP THAT LIMITS U.S. GOVERNMENT REIMBURSEMENT, AS WELL AS INSURERS’
LIABILITY, FOR LOSSES RESULTING FROM CERTIFIED ACTS OF TERRORISM. IF THE AGGREGATE
INSURED LOSS FOR ALL INSURERS EXCEEDS $100 BILLION IN A CALENDAR YEAR, YOUR COVERAGE
MAY THUS BE REDUCED.
Acceptance or Rejection of Terrorism Insurance Coverage with regard to General Liability
I hereby elect to purchase terrorism coverage for a prospective premium of $620.
I hereby decline to purchase terrorism coverage for certified acts of terrorism. I understand that I
will have no coverage for losses resulting from certified acts of terrorism.
_____________________________________ Safety National Casualty Corporation®
Applicant’s Signature Insurance Company
_____________________________________
Insured Name
____________________________________
Date Signed
8
Commercial Auto Liability Proposal
Safety National Casualty Corporation
A.M. Best Rating A++ XV
Self-Insured Retention Program
Named Insured City of Denton
Effective Date 12/31/2021
Expiration Date 12/31/2022
CA Coverage Form (CA 00 01) Symbol Limits of Liability
Auto Liability – Any One Accident 1 $2,000,000 Combined Single Limit –
Bodily Injury & Property Damage
Personal Injury Protection (PIP) 5 Excluded
Auto Medical Payments 2 Excluded
Uninsured/Underinsured Motorist (UM/UIM) 6 Excluded
Physical Damage Coverage Symbol Limits of Liability
Comprehensive Coverage 8 ACV
Collision Coverage 8 ACV
Coverage Retention Form (SNCA 022) Amount ALAE Treatment
Auto Liability – Any One Accident $500,000 ALAE Within Retention
Paid By Insured Comprehensive Coverage $50,000 deductible for
units valued $100,000 -
$599,999; $100,000
deductible for units valued
$600,000 and greater
Collision Coverage $50,000 deductible for
units valued $100,000 -
$599,999; $100,000
deductible for units valued
$600,000 and greater
Terms, Conditions, and Subjectivities include, but are not limited to:
• Confirm no APD claims pierced $50,000 x 10 years prior to binding coverage.
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Automobile Liability Coverages / Endorsements
Mandatory State Endorsements As required by covered states
Amphibious Vehicles CA 23 97
Audio, Visual, & Data Electronic Equipment
Coverage- Fire, Police, & Emergency Vehicles
CA 20 02
Auto Physical Damage Deductibles Applies to
Fire & Lightning
CAM 002
Broad Form Named Insured SNCA 038
Covered Auto Designation Symbol 8 CA 99 54
Emergency Services - Volunteer Firefighters’ and
Workers’ Injuries Excluded
CA 20 30
Exclusion of Federal Employees Using Autos in
Government Business
CA 04 42
Hired Autos Specified as Covered Autos you Own CA 99 16
Nuclear Energy Liability Exclusion IL 00 21
Public Entity Endorsement SNCA 029
Public Transportation Autos CA 24 02
Self-Insured Retention Endorsement SNCA 022
Silica Exclusion CA 23 94
Unintentional Failure to Disclose Material Facts SNCA 028
Unintentional Failure to Provide Notice of
Accident or Loss
SNCA 030
Waiver of Premium Audit Condition CAM 001
UM/UIM, PIP, and/or Med Pay coverage If the insured’s intent is to reject UM/UIM,
PIP, and/or Med Pay coverage in states that
allow total rejection and the state mandatory
forms are not signed, dated and returned
prior to a loss, the insured’s SIR will apply
to the claim, if payments are made.
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Public Officials & Employment Practices
Liability Proposal
Safety Specialty Insurance Company
A.M. Best Rating A++ XV
Self-Insured Retention Program
Named Insured City of Denton
Effective Date 12/31/2021
Expiration Date 12/31/2022
POL/EPL Coverage Form (POEPOF 0416) Limits of Liability
Occurrence Form
Annual Aggregate Limit $2,000,000
Each Wrongful Act $2,000,000
Coverage Retention Form (ILSIR 0716) Amount ALAE Treatment
Each Wrongful Act $500,000 ALAE Within Retention
Paid By Insured
Forms:
• Mandatory State Forms
• Non-Stacking of Limits Endorsement – Form ILNONSTACK 0416
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Law Enforcement Liability Proposal
Safety Specialty Insurance Company
A.M. Best Rating A++ XV
Self-Insured Retention Program
Named Insured City of Denton
Effective Date 12/31/2021
Expiration Date 12/31/2022
LEL Coverage Form (LELPOF 0416) Limits of Liability
Occurrence Form
Annual Aggregate Limit $2,000,000
Each Occurrence Limit $2,000,000
Coverage Retention Form (ILSIR 0716) Amount ALAE Treatment
Each Occurrence (including LAE) $500,000 ALAE Within Retention
Paid By Insured
Forms:
• Mandatory State Forms
• Non-Stacking of Limits Endorsement – Form ILNONSTACK 0416
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Commercial Excess Liability Proposal
Safety National Casualty Corporation
A.M. Best Rating A++ XV
Self-Insured Retention Program
Named Insured City of Denton
Effective Date 12/31/2021
Expiration Date 12/31/2022
Commercial Excess Coverage Form (CX 00 01) Limits of Liability
General Aggregate Limit $3,000,000
Each Occurrence Limit $3,000,000
Underlying Insurance Limits of Liability
General Liability Coverage $2,000,000/$4,000,000
Commercial Automobile Liability Coverage $2,000,000 CSL
Public Officials Liability Coverage $2,000,000/$2,000,000
Law Enforcement Liability Coverage $2,000,000/$2,000,000
All underlying coverages must be bound through Safety National Casualty Corporation or Safety
Specialty Insurance Company.
Exclusions:
In addition to all exclusions in the underlying Insurance, the following will also be excluded:
1.) Terrorism CX 21 33
2.) Failure to Supply XLM 001
13
POLICYHOLDER DISCLOSURE
NOTICE OF TERRORISM
INSURANCE COVERAGE
(Excess Liability)
You are hereby notified that under the Terrorism Risk Insurance Act of 2002, as amended, extended, and/or re-authorized,
you have a right to purchase insurance coverage for losses resulting from acts of terrorism, as defined in Section 102(1) of
the Act: The term “act of terrorism” means any act that is certified by the Secretary of the Treasury – in concurrence with
the Secretary of State and the Attorney General of the United States – to be an act of terrorism; to be a violent act or an act
that is dangerous to human life, property, or infrastructure; to have resulted in damage within the United States, or outside
the United States in the case of certain air carriers or vessels or the premises of a United States mission; and to have been
committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to
influence the policy or affect the conduct of the United States Government by coercion.
YOU SHOULD KNOW THAT WHERE COVERAGE IS PROVIDED BY THIS POLICY FOR LOSSES RESULTING
FROM CERTIFIED ACTS OF TERRORISM, SUCH LOSSES MAY BE PARTIALLY REIMBURSED BY THE
UNITED STATES GOVERNMENT UNDER A FORMULA ESTABLISHED BY FEDERAL LAW. HOWEVER, YOUR
POLICY MAY CONTAIN OTHER EXCLUSIONS WHICH MIGHT AFFECT YOUR COVERAGE, SUCH AS AN
EXCLUSION FOR NUCLEAR EVENTS. UNDER THE FORMULA, THE UNITED STATES GOVERNMENT
GENERALLY REIMBURSES 80% OF COVERED TERRORISM LOSSES EXCEEDING THE STATUTORILY
ESTABLISHED DEDUCTIBLE PAID BY THE INSURANCE COMPANY PROVIDING THE COVERAGE. THE
PREMIUM CHARGED FOR THIS COVERAGE IS PROVIDED BELOW AND DOES NOT INCLUDE ANY
CHARGES FOR THE PORTION OF LOSS THAT MAY BE COVERED BY THE FEDERAL GOVERNMENT UNDER
THE ACT.
YOU SHOULD ALSO KNOW THAT THE TERRORISM RISK INSURANCE ACT, AS AMENDED, CONTAINS A
$100 BILLION CAP THAT LIMITS U.S. GOVERNMENT REIMBURSEMENT, AS WELL AS INSURERS’
LIABILITY, FOR LOSSES RESULTING FROM CERTIFIED ACTS OF TERRORISM. IF THE AGGREGATE
INSURED LOSS FOR ALL INSURERS EXCEEDS $100 BILLION IN A CALENDAR YEAR, YOUR COVERAGE
MAY THUS BE REDUCED.
Acceptance or Rejection of Terrorism Insurance Coverage with regard to Excess Liability
I hereby elect to purchase terrorism coverage for a prospective premium of $1,805.
I hereby decline to purchase terrorism coverage for certified acts of terrorism. I understand that I
will have no coverage for losses resulting from certified acts of terrorism.
_____________________________________ Safety National Casualty Corporation®
Applicant’s Signature Insurance Company
_____________________________________
Insured Name
____________________________________
Date Signed